Helpmeet by Naben Ruthnum (Undertow Publications 2022)
In a former life, so to speak, I worked as a subject librarian at a university medical library. To the uninitiated, this might suggest that I needed to possess a fair degree of knowledge of Medicine in order to do the job justice. This may have been the case for those in such positions in days past, but by the time I undertook the responsibility, the expertise and professionalism of the academic librarian had come to be less associated with the subject in their job title and more related to their bibliographic ability to manage a library collection, whichever subject the collection might cover.
I mention this because, when handling some of the books that formed the medical library, I came somewhat unexpectedly to look upon a good many photographic images of diseases and conditions reproduced among the pages of the anatomy textbooks and journals, the likes of which I had not previously witnessed. It would be fair to say that I was entirely unprepared for what I found. ‘Hair-raising’ just about covers it. You think you know all that can go wrong with the human body. Trust me, you do not.
The representation of the nature and progression of physiological disease as a theme in horror literature is not especially widespread, at least not when presented in a sympathetic rather than a horrific light. The detailing of aggressive corporeal decomposition is perhaps, for many readers, a little too close to the grim realities of cancer to be considered as suitable subject matter for an entertainment, and yet this is precisely the territory that Naben Ruthnum’s slender novella Helpmeet inhabits.
The story concerns Edward and Louise Wilk, late Nineteenth Century New Yorkers in the Edith Wharton tradition, who leave the city for the old Wilk family home in the rural reaches of New York State beyond Buffalo, when the mysterious disease affecting Edward, a former surgeon, becomes ever more advanced. Louise, previously a nurse, dedicates herself to easing her spouse’s terrible plight, tending his wounds and lesions with an unwavering devotion.
There is the suggestion in the opening chapters that Edward’s illness may possibly have been sexually transmitted, perhaps some extreme form of syphilis, as episodes from his promiscuous past receive mention. So, it is all the more touching to consider the depth of Louise’s nonjudgmental dedication to her husband in light of this history. Her gentility in the face of the condition that ravages Edward’s body brings great poignancy to the passages that detail her caregiving. It becomes apparent very quickly that this is no ordinary affliction, and it is in the succinct descriptions of the effects of Edward’s ailment that Ruthnum delivers the most memorable prose in the story:
It’s sipping at my eyes now, Edward had said in October, less than a month after he trimmed the last of his nose away. He used to speak this way to patients, giving their ills verbs, explaining diseases as intrusive creatures that could be bargained with. The habit carried over to his own sickness.This isn’t like the nose.
That came off, like it was being picked at, pulled, tugged, like taffy. This is from the inside. I can feel it when I’m going to sleep. Through the optic nerves. Drinking, gently, slowly, like brandy punch through a straw. And when the eyes were extinguished, it almost looked as though Edward was right. The red cords behind his light green eyes swelled as the humours in the eyeballs leeched away, leaving deflated necrotic tissues that the last colleague Edward trusted, Dr. Clement Bannister, cleared away in a clamping, snipping, swapping procedure that Louise assisted in Edward’s study.
The story is a study of the dignity of a dying man and the love and kindness of his adoring wife. And yet, as we learn more about the nature of the disease that is killing Edward, it becomes apparent that this ‘illness’ is not quite what it seems. The property that the Wilks move to, where Edward wishes to spend the final days of his life, possesses an extensive orchard within its grounds.
The description of this leads one to conjure with the notion that, much as the apples fall from the trees and rot in order to propagate their seeds, the malady affecting Edward is not so much a death sentence as a life cycle. And so, without wishing to reveal too much, instead of a tragic ending, we witness the strangest form of hope emerge from the bizarre process that Edward (and ultimately Louise also) passes through. To read it is to understand the value of rot and regeneration.
Ruthnum’s tale is going to be too short in length for some readers. At just 85 pages, it could be regarded as insubstantial to the point of superfluous, and thereby not worthy of interest. However, there is something in its measured brevity that suits the somewhat distanced view that we are given of the couple’s suffering and endurance. It is a glimpse into a very private world, and to linger for any greater length of time would be to disrupt the dignity that is depicted. Some stories benefit from being ‘devoured’ in one sitting. Helpmeet is such a book; to dwell for too long amid the characters’ private grief would only serve to diminish its impact.
The cover of the novella features the painting ‘The Woman with the Candlestick (circa 1825)’ by Caspar David Friedrich. The dark, desaturated palette, coupled with the image of a woman at the far end of a corridor looking at something beyond our view, makes for a fine encapsulation of the devotion required to look upon the suffering of a loved one, and the respect that that deserves.
Helpmeet by Naben Ruthnum

It’s 1900, and Louise Wilk is taking her dying husband home to Buffalo where he grew up. Dr. Edward Wilk is wasting away from an aggressive and debilitating malady. But it’s becoming clearer that his condition isn’t exactly a disease, but a phase of existence that seeks to transform and ultimately possess him.
“At the bitter end of the 19th century, a loyal wife cares tenderly for her dissolute husband as he nears his death from a mysterious, gruesomely corrosive disease. Helpmeet by Naben Ruthnum is a sumptuous excursion into surreal body horror and an unsparing exploration of the extreme frontiers of connubial devotion.
Ruthnum delivers a uniquely unsettling Gothic love story—and it is first and foremost a love story—evoking the grisly Edwardian tales of W.W. Jacobs, William Hope Hodgson and Algernon Blackwood, while drawing in such modern masters as Barker, Del Toro and Cronenberg. Brief enough to be read in an evening, it holds certain images so grotesque that they will linger in your dreams for weeks.”
– David Demchuk, Award-winning author of The Bone Mother, and RED X
Naben Ruthnum is the author of Curry: Eating, Reading, and Race and A Hero of Our Time. He also writes thrillers as Nathan Ripley. His short fiction has won the Journey Prize and a National Magazine Award.
Praise for Helpmeet by Naben Ruthnum
“Naben Ruthnum’s Helpmeet is a remarkable throwback. The style, the precise prose, the lush imagery, the dreadful sense of wheels turning just past the reader’s sightline—I devoured it in a few delighted hours and it took me back to my teenage years, to afternoons squirreled away in the corner of my local library reading Clark Ashton Smith, Robert Chambers, Algernon Blackwood and the other great elder wordsmiths I cut my horror teeth on.”
– Craig Davidson, Author of The Saturday Night Ghost Club
“An everyday tragedy spirals into a medical mystery and then into something much darker and more disquieting, executed in prose that glitters like candlelight on an open wound. I loved this intensely claustrophobic study of a complicated marriage twisting itself into something monstrous.”
– Premee Mohamed, Author of the Beneath the Rising Trilogy
“In a wholly unique spot between the New York society novels of Henry James and Edith Wharton and the best body horror of David Cronenberg lurks the strange, disturbing and ultimately transcendent novella Helpmeet. Naben Ruthnum’s pitch-perfect pastiche is as all-consuming as the disease at its heart, a fever dream of a story as original, elegantly written and chilling as anything I’ve read in recent memory.”
– Pasha Malla, Author of Fugue States, and Kill the Mall
“Naben Ruthnum’s succinctly brilliant Helpmeet finds the thin line between intimacy and body horror, and blurs it to create a unique love story that is as moving as it is disturbing.”
– Indrapramit Das, Author of The Devourers
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